Saturday, May 17, 2014

Red Sky at Night

Photo by James Calemine

Spring began in earnest for Parrish and me about 10 days ago. As the air filled with the fragrance of jasmine and ligustrum, and lilies began to bloom, his head began to clear. His thoughts took on an order I have not seen since he was a young man. The fog of paranoia and anxiety lifted, and his thoughts became more clear and organized. The black smudges of fatigue disappeared from around his eyes, the cables of tension in his brow melted away, and his perpetual frown lifted.

The change seemed to happen overnight, but there were struggles. Two weeks ago, he was drinking, and there ensued the usual aftermath of resentment and paranoia and mania. We were all, including Parrish, ready to give up this fight, feeling as though there were nothing left to do, no way to escape the toxic fallout from his mental illness and alcoholism. We were exhausted by it’s debilitating negative energy, and even my dog, Honey, was skittish and fractious. She refused to let P take her to walk, and when he was at his worst, she hid on the floor between my bed and the wall. I was wading in the edge of an ocean of depression, in danger of being pulled down by its currents into the unthinkable black place I have visited in the past. My eyes were as dark and hollow as his, and his father wore a startled look that smacked of dread and fear. Parrish was riddled with guilt, unable to control his urges to drink. For weeks he hadn’t slept more than two hours at a time, and he often he didn’t sleep at all for several days. As a result, I was sleep deprived as well. 

Thus we arrived at the decision to challenge Parrish to stay sober or find a way to make it on his own. 

“I can live with your mental illness, but I can’t do crazy and drunk. I simply cannot do it any more,” I said to him. 

“Buy a breathalyzer! I need a serious motivator,” he pleaded. “If I know I’ll be tested every time I come in the door, and that I will be asked to leave if I’ve been drinking, it will help me fight the urges. At this point, fear is about the only thing that will stop me from drinking -  if I can stop at all. God! I wish that shot would take effect.” 

Two weeks before that episode, when he was in the Crisis Stabilization Unit (CSU) after his most recent mania-driven suicide attempt, Parrish’s doctor changed his medicine yet another time, still searching for the right mix of drugs for him. He gave him a injection of Abilify Maintena, a time released anti-psychotic that is given once a month. Because of his involvement with Gateway, the local public mental health organization, he the shot was free. The retail price is just under $1600.00. The doctor ordered oral Abilify for him to take for two weeks, hoping to get the drug into his system sooner than the expected waiting period of one month.

Despite not drinking, insomnia continued to be a problem. Parrish’s psychiatrist prescribed sleeping pills, but they didn’t work. After three days, he prescribed a different drug, but it failed as well. Finally, he ordered a trial of Rozerem, a medicine that is relatively new, having been approved for use in the United States only six years ago. The first night, Parrish slept four hours without waking, and we were encouraged.  There followed a succession of nights when he slept longer every night, and he slept for nine hours last night, awaking only once.

Parrish had surgery last week to remove all of his lower teeth. There can be no doubt that pain is activating and that brain chemicals are powerful enough to override sedation and analgesics. That fact was borne out after the operation. Although he was relatively calm before the procedure, he emerged from anesthesia in a frenzy. In spite of the anesthesia, he was in pain and could not relax. 

“Drive through at McDonald’s, please! I need a milkshake.” 

He slurped down the shake in a matter of moments. I hoped the cool liquid would ease his discomfort and perhaps help stem the steady flow of blood oozing from his gums, but the gauze packing in his mouth was soon soaked. He kept taking it out to talk.

“I am so damned glad that is over with! I’m just so damned happy.” 

He repeated that statement a dozen times while his gums continued to bleed, and no manner of encouragement, or even castigation, from me could calm him. He was elated to have the procedure behind him, and his joyous mania overrode any self control he might have had under different circumstances. When there was blood dripping onto the front of his white tee shirt, leaving a pattern of red rose petals, he changed the packing. That shirt made me think of all the times he has flung crazy up all over our flat when drinking and manic, creating a virtual Jackson Pollack painting in angry flames of color. 

When the packing was drenched, he used the box of tissues in my car to stem the flow of blood until we got home. As soon as I unlocked the door to our flat and before I could set down my purse and keys, in a fit of brain overload - mouth still oozing blood - P took the mailbox key and went downstairs to fetch the mail. 

When he returned, I medicated him, but Lortab had little affect on his pain. Extra Xanax did nothing to assuage his anxiety. Medicine doesn’t work on a brain that is as agitated as his was. He continued to bleed, and his daddy and I took turns soaking tea bags and applying them to his mouth. 

48 hours passed before P’s pain was under control and the bleeding stopped completely. At one point, thinking I smelled alcohol on his breath, I had him blow into the breathalyzer. He said he had rinsed his mouth with mouth wash, a brand which is supposed to be alcohol-free. The machine registered  a small amount of alcohol in his breath, and he insisted I rinse with the wash and blow into the device myself. I also tested positive for alcohol. I sagged under the weight of enormous relief. What would I have done if I had tested negative? Kicked him out three days after surgery? 

Since the turmoil that followed his oral surgery, P has continued to improve, and every day I see a calmer, more organized and self reliant man. Yesterday morning, he spent nearly an hour on the phone with Social Security - 45 minutes of that time on hold - to iron out a problem with his disability benefits. He made not so much as a glance in my direction for guidance. A month ago, it would have been impossible for him to handle that situation. He is more composed and less moody. He recognizes changes in his frame of mind and works to minimize them, using exercise and breathing techniques. He continues to experience spontaneous tears even when he doesn’t feel sad.

So, what happened? I believe it was a combination of his will to stay sober - and thus remain living here with me - and the coming together of the medicine in his body in a way that works for him. He is also taking Prozac for social anxiety, and we both see improvement there. A month ago, he couldn’t go anywhere - for any reason - without being overpowered by anxiety. Yesterday afternoon, we went to the Pier Village to meet his father when he climbed up the ladder from the pilot boat after taking out a massive ship. Parrish was excited but not inappropriately so. Before his dad arrived at the pier, we ate an early dinner at the top floor of a restaurant with views of the sound, an activity that up until now was out of the question. The last time we tried to go out to eat was two months ago, and we ended up taking our food home with us because the proximity of so many people drove P into a state of panic and mania. But yesterday, we had a leisurely meal and left the restaurant and walked a few steps up the street to the yogurt shop we now frequent. We got so comfortable that we missed P’s daddy coming off the pilot boat. We were walking down to the pier when he pulled up beside us in is car wanting to know where we had been. It is miraculous that we can go off together and enjoy ourselves so much that we lose track of time.

As for me, I have taken on what feels like a pall of depression, which is temporary, I believe, and not doubt a result of the pressure being off. For months I was the benevolent prison warden, dressed and made-up every day in order to be prepared for the next crisis. Now that I can relax in my own home, I am sleeping 12 or 14 hours a day, writing when I can, doing some editing work when I can. I am choosing to believe that I’m simply exhausted and now have time to give in to my fatigue, let it roll over me like a wave, take me back to myself.

Yes, spring has begun for us. I have been watching a spider lily bloom over the past several days, and it gives me great hope that we are at the edge of a new beginning. Two days ago, the sun dropped down over an horizon that was painted in brilliant scarlet and orange, foreshadowing fair sailing.

On Tuesday, I start art classes.

Copyright 2014 
cj Schlottman

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